Effectiveness of exercise intervention during pregnancy on high-risk women for gestational diabetes mellitus prevention: A meta-analysis of published RCTs

We aimed at investigating the preventive role of exercise intervention during pregnancy, in high-risk women for gestational diabetes mellitus (GDM). We searched PubMed, CENTRAL, and Scopus for randomized controlled trials (RCTs) that evaluated exercise interventions during pregnancy on women at high...

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Bibliographic Details
Published in:PloS one 2022-08, Vol.17 (8), p.e0272711-e0272711
Main Authors: Tsironikos, Georgios I, Perivoliotis, Konstantinos, Bargiota, Alexandra, Zintzaras, Elias, Doxani, Chrysoula, Tatsioni, Athina
Format: Article
Language:English
Subjects:
Bias
Biology and Life Sciences
Care and treatment
Collaboration
Confidence intervals
Diabetes in pregnancy
Diabetes mellitus
Diagnosis
Education
Evaluation
Exercise
Exercise therapy
Feasibility studies
Gestational diabetes
Health aspects
Health risks
Heterogeneity
Intervention
Keywords
Lifestyles
Medicine and Health Sciences
Meta-analysis
Motivation
Patient outcomes
Physical fitness
Physical Sciences
Population studies
Pregnancy
Pregnant women
Prenatal care
Prevention
Research and Analysis Methods
Risk factors
Sensitivity analysis
Social Sciences
Statistical analysis
Womens health
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Summary:We aimed at investigating the preventive role of exercise intervention during pregnancy, in high-risk women for gestational diabetes mellitus (GDM). We searched PubMed, CENTRAL, and Scopus for randomized controlled trials (RCTs) that evaluated exercise interventions during pregnancy on women at high risk for GDM. Data were combined with random effects models. Between study heterogeneity (Cochran's Q statistic) and the extent of study effects variability [I.sup.2 with 95% confidence interval (CI)] were estimated. Sensitivity analyses examined the effect of population, intervention, and study characteristics. We also evaluated the potential for publication bias. Among the 1,508 high-risk women who were analyzed in 9 RCTs, 374 (24.8%) [160 (21.4%) in intervention, and 214 (28.1%) in control group] developed GDM. Women who received exercise intervention during pregnancy were less likely to develop GDM compared to those who followed the standard prenatal care (OR 0.70, 95%CI 0.52, 0.93; P-value 0.02) [Q 10.08, P-value 0.26; I.sup.2 21% (95%CI 0, 62%]. Studies with low attrition bias also showed a similar result (OR 0.70, 95%CI 0.51, 0.97; P-value 0.03). A protective effect was also supported when analysis was limited to studies including women with low education level (OR 0.55; 95%CI 0.40, 0.74; P-value 0.0001); studies with exercise intervention duration more than 20 weeks (OR 0.54; 95%CI 0.40, 0.74; P-value 0.0007); and studies with a motivation component in the intervention (OR 0.69, 95%CI 0.50, 0.96; P-value 0.03). We could not exclude large variability in study effects because the upper limit of I.sup.2 confidence interval was higher than 50% for all analyses. There was no conclusive evidence for small study effects (P-value 0.31). Our study might support a protective effect of exercise intervention during pregnancy for high-risk women to prevent GDM. The protective result should be corroborated by large, high quality RCTs.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0272711